Comparing 30-Day Morbidity and Mortality in Pediatric and Adult Otologic Surgery

作者：Schwam Zachary G^*; Michaelides Elias; Schwam Jennifer R; Kuo Phoebe; Hajek Michael A; Judson Benjamin L; Schutt Christopher

来源：Otolaryngology - Head and Neck Surgery, 2017, 157(5): 830-836.

DOI：10.1177/0194599817704376

• otology
• postoperative complications
• NSQIP
• NSQIP-P
• adult otology
• pediatric otology
• otologic surgery
• hearing loss

Objective To determine differences in timing and rate of postoperative adverse events among pediatric and adult populations undergoing specific otologic procedures.
Study Design Administrative database study.
Setting Multi-institutional database.
Subjects and Methods The National Surgical Quality Improvement Program (NSQIP) and NSQIP-Pediatric (NSQIP-P) were used to extract data from 819 adults (years 2005-2010) and 7020 children (years 2012-2014) undergoing tympanoplasty and (tympano)mastoidectomy, respectively. Simple summary statistics, (2), and multivariable logistic regression analyses were performed.
Results There were no significant differences in overall adverse event rates between adults (2.9%) and children (2.3%) (P = .233). Adults experienced infectious complications more frequently than did children (0.4% vs 0.0%, P = .002). Postdischarge complications accounted for 83.7% of all complications. Children treated by pediatric otolaryngologists had higher readmission rates (odds ratio [OR], 2.80; 95% confidence interval [CI], 1.20-3.60; P = .002). Tympanomastoidectomy was associated with higher odds of reoperation (OR, 1.02; 95% CI, 1.01-1.03; P < .001), as was undergoing a concurrent procedure that did not include myringotomy (OR, 3.38; 95% CI, 1.47-7.79; P = .004).
Conclusion Both adult and pediatric otologic surgery are safe, with patients experiencing similarly low complication rates. Most adverse events occur after discharge.

• 出版日期2017-11